Focus of talks: Giving arms, legs back to amputees

When people lose an arm or a leg, there is always grief, said Col. Jennifer Menetrez, M.D. But there is also a new awareness of what amputees can do.

Some run a marathon, some play sled hockey (a form of ice hockey, complete with body slams), some use a FlowRider — like those featured on cruise ships — to do a form of indoor surfing.

“It’s not about what they could do before. It’s about all the things they didn’t realize they could do that they now are forced to try,” she said.

Col. Menetrez, director of the Center for the Intrepid at Brooke Army Medical Center in San Antonio, spoke yesterday at Neuroprosthetics 2010, an international symposium at Worcester Polytechnic Institute focused on implantable artificial limbs and prosthetic devices. Other speakers were scheduled to talk about fusing metal posts into amputees’ bones (osseointegration), the challenge of getting the body to form an infection-resistant seal around such a post (soft tissue integration) and how prosthetics might eventually work with an amputee’s nervous system, allowing for fine motor control.

WPI’s Bioengineering Institute sponsored the event, which was aimed at scientists, clinicians, manufacturers, veterans and others.

Col. Menetrez helped provide the background for solutions. She urged the crowd of researchers and students to think about why a doctor would want to prescribe a given device over what already exists. As someone who led the military medical response to the Haiti earthquake for three months, she also reminded them that the conditions under which a prosthetic might work in the U.S. do not necessarily exist abroad; amputees need to be able to do some of the adjustments and repairs to their prosthetics themselves. In Haiti, for instance, people didn’t always have appropriate wheelchairs, and getting to a rehab clinic was a workout itself.

Many amputees are “chomping at the bit” to rejoin their fellow soldiers, state Secretary of Veterans’ Services Thomas G. Kelley said, and Col. Menetrez noted that amputees do return to the field.

“Sometimes our patients are going to be God knows where, maybe deployed again, and they’re going to have their extra legs in their bag” and won’t be able to get to their prosthetist to have their leg adjusted or fixed when something goes wrong, she said.

Col. Menetrez works with wounded soldiers, but the majority of the country’s amputees come from vascular problems related to diabetes or other issues, she said. In terms of soldiers, however, there have been 826 amputees from the Iraq war and 271 from the war in Afghanistan, she said. About 20 percent of those soldiers lost more than one limb.

“Our patients were in a war. They were blown up,” she said.

Her patients also sound indestructible, but recovering from the trauma they’ve suffered takes a lot of different kinds of help, Col. Menetrez said. The Center for the Intrepid houses much of it under one roof: physical and occupational therapy, case management, research, veterans’ services and connections to the soldier’s unit.